Psychiatric disorders in women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is the most commonly diagnosed endocrine disorder in women of reproductive age, affecting approximately 5-8% of females in this group. It is characterized by hyperandrogenism, abnormal periods (rare periods or amenorrhea) and polycystic ovaries visualized through ultrasonography. The etiopathogenesis of polycystic ovary syndrome has not been elucidated in detail. There are numerous hypotheses on this subject which tend to complement one another. The most widely recognized hypothesis is that the development of PCOS is due to insulin resistance and hyperinsulinemia, which subsequently lead to hyperandrogenism. On the basis of an as of yet relatively small number of studies, an increased prevalence of various psychiatric disorders can be observed in women with PCOS. These include: depression, generalized anxiety disorder, personality disorders, social phobia, obsessive-compulsive disorder, attention deficit hyperactivity disorder (ADHD), and eating disorders. Bipolar affective disorder, schizophrenia and other psychotic disorders have also been reported in women with PCOS more often than in the general population. The higher prevalence of psychiatric disorders in patients with PCOS, especially depression and anxiety disorders, may be due to both hyperandrogenism and the resulting somatic symptoms. These symptoms can undoubtedly be stigmatizing for women and lower their quality of life. This article is intended to provide an overview of the literature regarding mental disorders associated with polycystic ovary syndrome and to present own research on depression and sexual dysfunction in this group.